title: Sexual victimization, health status, and VA healthcare utilization among lesbian and bisexual OEF/OIF veterans.
abstract: BACKGROUND
  Many lesbian and bisexual (LB) women veterans may have been targets of victimization in the military based on their gender and presumed sexual orientation, and yet little is known regarding the health or mental health of LB veterans, nor the degree to which they feel comfortable receiving care in the VA.
  
  
  OBJECTIVE
  The purpose of this study was to examine the prevalence of mental health and gender-specific conditions, VA healthcare satisfaction and trauma exposure among LB veterans receiving VA care compared with heterosexually-identified women veterans receiving.
  
  
  METHODS
  Prospective cohort study of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) women veterans at two large VA facilities.
  
  
  METHODS
  Three hundred and sixty five women veterans that completed a baseline survey. Thirty-five veterans (9.6 %) identified as gay or lesbian (4.7 %), or bisexual (4.9 %).
  
  
  METHODS
  Measures included sexual orientation, military sexual trauma, mental and gender-specific health diagnoses, and VA healthcare utilization and satisfaction.
  
  
  RESULTS
  LB OEF/OIF veterans were significantly more likely to have experienced both military and childhood sexual trauma than heterosexual women (MST: 31 % vs. 13 %, p < .001; childhood sexual trauma: 60 % vs. 36 %, p = .01), to be hazardous drinkers (32 % vs. 16 %, p = .03) and rate their current mental health as worse than before deployment (35 % vs. 16 %, p < .001).
  
  
  CONCLUSIONS
  Many LB veterans have experienced sexual victimization, both within the military and as children, and struggle with substance abuse and poor mental health. Health care providers working with female Veterans should be aware of high rates of military sexual trauma and childhood abuse and refer women to appropriate VA treatment and support groups for sequelae of these experiences. Future research should focus on expanding this study to include a larger and more diverse sample of lesbian, gay, bisexual, and transgender veterans receiving care at VA facilities across the country.
authors.affiliation: VA Central Western Massachusetts, Leeds, MA, USA. Kristin.mattocks@va.gov
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Mattocks
authors.forename: Anne
authors.initials: A
authors.lastname: Sadler
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Yano
authors.forename: Erin E
authors.initials: EE
authors.lastname: Krebs
authors.forename: Laurie
authors.initials: L
authors.lastname: Zephyrin
authors.forename: Cynthia
authors.initials: C
authors.lastname: Brandt
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.forename: Theo
authors.initials: T
authors.lastname: Sandfort
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Dichter
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Weiss
authors.forename: Jeroan
authors.initials: J
authors.lastname: Allison
authors.forename: Sally
authors.initials: S
authors.lastname: Haskell
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001727:Bisexuality / Q000523:psychology*; D015331:Cohort Studies; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D006304:Health Status; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011446:Prospective Studies; D012742:Sex Offenses / Q000517:prevention & control / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology*; D058014:Veterans Health